MS

Question 0

Effects of ms on pregnancy

Answer 0

No increase of miscarriage, stillbirth or abnormalities

Lifetime risk of ms for baby is 3% if only one parent affected

Postpartum relapse may interfere with bonding

Maternal exhaustion in labour may necessitate assisted delivery

Question 1

Effects of pregnancy on ms

Answer 1

Risk of relapse is reduced in pregnancy

Increased within 3 month post partum

No long term effect of pregnancy on the progression of ms

Pregnancy may aggravate urinary/bowel dysfunction

Increased risk of UTIs

Regional anaesthetic not contraindicated

Breastfeeding may prevent relapse

Question 2

Treatment of ms

Answer 2

Disease modifying drugs - interferon, glatiramer, natalizumab are licensed to reduce the frequency of the attacks slowing the disability progression

They should be avoided in pregnancy and breast feeding

Question 3

Contraception in ms

Answer 3

May not be necessary as 50-90% of sufferers have loss of libido, incontinence during coitus, muscle weakness and fatigue

Diaphragms is not good due to parestesia

Estrogen may be contraindicated because of limb para paresis and immobility